Zubaran Carlos, Medeiros Gregory, Foresti Katia, May William, Michelim Lessandra, Madi José Mauro
a School of Medicine , University of Western Sydney , Sydney , Australia.
AIDS Care. 2014;26(5):619-25. doi: 10.1080/09540121.2013.841838. Epub 2013 Oct 4.
The absence of or limited adherence to treatment is the main cause for the failure of Highly Active Antiretroviral Therapy (HAART). In Brazil, adherence to antiretroviral therapy has been lower than the recommended levels. Although HAART may produce adverse reactions, failure to comply with it may aggravate patients' health status and impair Quality of Life (QoL). The QoL of individuals living chronically with HIV and AIDS has been considered one of the main treatment outcomes. This study is part of a 225-day prospective trial in which participants were enrolled in two different modalities of follow-up: the usual model medical follow-up or an intervention based on the Medication Adherence Training Instrument (MATI). The WHOQOL-HIV BREF questionnaire was used to evaluate QoL of research participants in both groups on the 15th and 225th days of follow-up after the baseline assessment. The result of this study revealed no significant differences of WHOQOL-HIV BREF scores between participants allocated to MATI and non-MATI groups in the first assessment. However, there was a significant difference between the scores obtained on the 15th and 225th days in the domain related to spirituality and personal beliefs irrespective of the modality of follow-up. Other domains of the WHOQOL-HOV BREF remained unchanged. These results indicate that, in this sample, personal beliefs and spirituality may be relevant subjects to explain sustained levels of adherence to HAART.
不进行治疗或有限地坚持治疗是高效抗逆转录病毒疗法(HAART)失败的主要原因。在巴西,对抗逆转录病毒疗法的坚持程度低于推荐水平。尽管HAART可能会产生不良反应,但不遵守该疗法可能会使患者的健康状况恶化并损害生活质量(QoL)。长期感染艾滋病毒和艾滋病患者的生活质量一直被视为主要的治疗成果之一。本研究是一项为期225天的前瞻性试验的一部分,参与者被纳入两种不同的随访模式:常规的医学随访模式或基于药物依从性训练工具(MATI)的干预措施。在基线评估后的随访第15天和第225天,使用世界卫生组织生活质量艾滋病毒BREF问卷来评估两组研究参与者的生活质量。本研究结果显示,在首次评估中,分配到MATI组和非MATI组的参与者之间,世界卫生组织生活质量艾滋病毒BREF评分没有显著差异。然而,无论随访模式如何,在与精神性和个人信仰相关的领域中,第15天和第225天获得的分数存在显著差异。世界卫生组织生活质量艾滋病毒BREF的其他领域保持不变。这些结果表明,在这个样本中,个人信仰和精神性可能是解释对HAART持续坚持程度的相关主题。